title: Blood glucose monitoring and glycemic control in adolescents with type 1 diabetes: meter downloads versus self-report.
abstract: BACKGROUND
  Reported frequencies of blood glucose monitoring (BGM) by both adolescents and their caregivers serve as adherence proxies when meter downloads are not available. Yet, correlates of reported BGM frequencies and their predictive utility are understudied.
  
  
  OBJECTIVE
  To identify sociodemographic, psychological, and disease-specific correlates of reported BGM frequencies in adolescents with type 1 diabetes and to explore the predictive utility of BGM indices on glycemic control.
  
  
  METHODS
  Study participants included caregivers and adolescents with type 1 diabetes (N=143, 13-18 yr) receiving diabetes treatment at a tertiary care setting.
  
  
  METHODS
  At the initial visit, adolescents and caregivers reported on daily BGM frequencies. A sub-sample provided meter downloads. Adolescents also completed a depression inventory. Three months later, adolescents provided blood sampling for A1c assessment.
  
  
  RESULTS
  Multivariate general linear modeling identified that older adolescent age and more depressive symptoms were associated with reports of less frequent BGM. Two stepwise multivariate regression models examined the predictive utility of BGM indices (i.e., adolescent-reported BGM, caregiver-reported BGM, meter download) on glycemic control. Caregiver-reported BGM frequency predicted glycemic control in the absence of meter download data (p<0.001). However, when clinical and contextual variables were included, meter download data were the most robust predictor of glycemic control (p<0.0001).
  
  
  CONCLUSIONS
  Meter downloads have the most robust association with glycemic control when contextual variables are considered. Caregiver-reported BGM frequencies can serve as reliable substitutes in the absence of meter download, but they may not be as reliable in adolescents with depressive symptoms.
authors.affiliation: Center for Adherence Promotion and Self-Management, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
authors.forename: Shanna M
authors.initials: SM
authors.lastname: Guilfoyle
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Crimmins
authors.forename: Korey K
authors.initials: KK
authors.lastname: Hood
mesh_terms: D000293:Adolescent; D015190:Blood Glucose Self-Monitoring / Q000295:instrumentation / Q000379:methods* / Q000523:psychology; D003863:Depression / Q000097:blood / Q000523:psychology; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D057566:Self Report
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; C517652:hemoglobin A1c protein, human